Citation: The treatment of penile carcinoma in situ (CIS) within a UK supra-regional
network.
BJU Int. 2015 Apr;115(4):595-8
Authors: Lucky M, Murthy KV, Rogers B, Jones S, Lau MW, Sangar VK, Parr
NJ
Abstract: OBJECTIVES: To review outcomes of the treatment of carcinoma in
situ (CIS) of the penis at a large supra-regional penile cancer network, where
centralisation has permitted greater experience with treatment outcomes, and
suggest treatment strategies. PATIENTS AND METHODS: The network penile cancer
database, which details presentation, treatment and complications was analysed
from 2003 to 2010, identifying patients with CIS, with a minimum follow-up of 2
years, looking at treatments administered and outcomes. RESULTS: In all, 57
patients with mean (range) age of 61 (34-91) years were identified. In all, 18
were treated by circumcision only, 20 by circumcision and local excision (LE)
and 19 by circumcision and 5-flurouracil (5-FU). The mean (range) follow-up was
3.5 (2-8) years. Of those treated by circumcision none subsequently developed
CIS on the glans. For those who underwent circumcision + LE, five of 20 (25%)
developed recurrence requiring further treatment. Of those treated by
circumcision + 5-FU, 14/19 (73.7%) completely responded. Of the five incomplete
responders, two had focal invasive malignancy at repeat biopsy. One incomplete
responder underwent glansectomy and four grafting. No complete responders
relapsed. Complications of 5-FU included significant inflammatory response in
seven (36.8%), with two requiring hospital admission and one neo-phimosis
(5.3%). CONCLUSION: This study suggests that patients undergoing circumcision
for isolated CIS and complete responders to 5-FU may require only short-term
follow-up, as recurrence is unlikely, whereas longer follow up is required for
all other patients. However, numbers in this study are small and larger studies
are needed to support this. An incomplete response to 5-FU dictates immediate
re-biopsy, as it carries a significant chance of previously undetected invasive
disease.
PMID: 25060513 [PubMed - indexed for MEDLINE]
Link to Pubmed record
